Anyone who has ever parented a preschooler has likely endured some degree of pickiness at the dinner table -- and been told by a well-meaning relative or doctor that it's just a passing phase.
But new research suggests picky eating is an issue parents and physicians should pay closer attention to, drawing a link between children's food-related selectivity and their risk for broader psychological issues, including anxiety and depression.
In the study, published in the journal Pediatrics on Monday, researchers with Duke University screened more than 3,400 kids between the ages of 2 and 5 and found that 20 percent met their criteria for so-called "selective eating." Those young children were often or always particular about what they'd eat.
But while the researchers found pickiness was relatively common, it was not necessarily benign.
When the team conducted interviews to assess the children's emotional functioning, they found that moderate and more severe picky eating was linked with concurrent anxiety and depression.
They also followed-up with a subset of the children two years after the study began and found that kids who were picky eaters as preschoolers were at greater risk for anxiety issues at that point, as well. The study cannot establish cause-and-effect -- nor did it aim to -- but William Copeland, an associate professor with the Duke University School of Medicine and an author on the study, told The Huffington Post the finding suggests there is a "complex interplay going on."
"Selective eating is a marker that parents and physicians need to gather more information on," Copeland argued. "Are they having other associated problems? How disruptive is this to the family?"
Of course, what constitutes "picky eating" is subjective, but for purposes of this study the researchers considered a child a selective eater if he or she only ate from a specific range of foods, or was so particular that eating with others was often difficult.
"We're not trying to set off alarms if your child just doesn't like broccoli," Copeland laughed. (In fact, interviewers did not even include cruciferous vegetables, like broccoli, when they spoke to parents about their young children's eating habits, because they're so widely disliked.)
If, however, a child's dislikes are so strong that parents regularly find themselves preparing different meals, for example, that is a red flag parents may want to raise with their child's pediatrician.
"As a clinician, a researcher and a father of three kids, I'm not overly prescriptive," Copeland said. "If [parents] have to adapt a little bit, and their child isn't experiencing other symptoms or signs of distress, I'm not going to make an issue out of that."
But ultimately he hopes the new study reminds pediatricians that "wait-and-see" is not always sufficient, and that not all children simply outgrow their picky eating.
"Hopefully," Copeland said, "this will raise awareness and help parents feel more comfortable bringing it up, and that physicians need to dig a little deeper before suggesting that they'll grow out of it and that it's of no concern."
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